Modular Retractor And Related Method

ABSTRACT

A retractor assembly for positioning tissue during a surgical procedure, having two opposing arms disposed adjacent to one another and sized and configured to be urged substantially laterally away from one another during actuation of the retractor assembly into an open position, and one or more posts, each post being connected to, or integral with, and extending radially outwardly from a respective one of the opposing arms, each of the one or more posts having a length sufficient so that each of the one or more posts will extend through a respective aperture defined by a modular component to be detachably attached to the respective one of the opposing arms. Related methods of positioning tissue during surgery are also described.

REFERENCE TO RELATED APPLICATIONS

This application is a continuation of copending and commonly-owned U.S.application Ser. No. 14/056,452, filed Oct. 17, 2013, which in turn is acontinuation of International Patent Application No. PCT/US2012/058998,filed on Oct. 5, 2012, which claims priority to commonly owned U.S.Provisional Patent Appl. No. 61/453,535, filed on Oct. 5, 2011, thedisclosures of which are incorporated herein by reference.

TECHNICAL FIELD

This invention pertains to the technical field of medical devices,namely retractors for use in orthopedic and other surgical procedures.

THE INVENTION

Retractors and retractor assemblies are commonly used to draw back andretain tissue from a surgical site. Many retractor designs are competentat retaining open an incision, but are less useful in isolating bone orother internal target areas while dependably retracting deeper tissuebelow the skin and below the shallow tissues which surround theincision. Conventional retractors, even those of the self-retaining typefor example, often require adjustment or manipulation by a surgicalassistant when retraction and/or isolation of deeper tissues might benecessary during a surgeon's work. Thus, a need persists for refractorapparatus with improved ease of use, efficiency of design andeffectiveness at tissue retraction and target isolation within thesurgical field.

The present invention addresses this need by providing, in one aspect, aretractor assembly for positioning tissue during a surgical procedure,the assembly comprising:

-   -   two opposing arms disposed adjacent to one another and sized and        configured to be urged substantially laterally away from one        another during actuation of the retractor assembly into an open        position,    -   one or more posts, each being connected to, or integral with,        and extending radially outwardly from a respective one of the        opposing arms, each of the one or more posts having a length        sufficient so that each of the one or more posts will extend        through a respective aperture defined by a modular component to        be detachably attached to the respective one of the opposing        arms.

It can be preferred, in certain aspects of the invention, that at leastone of the one or more posts is non-circular (e.g., square, rectangular,hexagonal, etc.) when viewed in cross-section through a longitudinalaxis thereof. The retractor assembly may further comprise a plurality ofposts extending from each of the opposing arms.

The retractor assembly may further comprise at least one modularcomponent, which component defines one or more apertures, each aperturebeing sized and configured to mate with a respective one of the posts tothereby detachably attach the modular component to the arm from whichthe respective one of the posts extends. In some aspects of theinvention, each aperture defined by the modular component is sized andconfigured to mate with the respective one of the posts so as to inhibitrotational motion of the modular component about the longitudinal axisof the respective one of the posts. The modular component further maycomprise a planar member forming one or more flanges. In such cases,preferably the one or more flanges is sized to extend into the surgicalfield when the modular component is detachably attached to therespective one of the opposing arms and the refractor assembly isdeployed in the open position during use. In one particular embodimentof the invention, the modular component comprises a Hohmann retractor.

In another aspect of this invention, there is provided a method ofpositioning tissue during a surgical procedure. The method comprises

-   -   detachably attaching a modular component to each of two opposing        arms of a self-retaining retractor assembly, by at least mating        respectively one or more apertures defined by a respective one        of the modular components with one or more posts, the one or        more posts being connected to or integral with and extending        radially outwardly from a respective one of the opposing arms;    -   disposing at least a portion of the modular components of each        of the two opposing arms into a surgical field; and    -   urging the opposing arms laterally away from one another and        into an open position so as to place the modular components into        contact with and to position the tissue during the surgical        procedure.        In at least some embodiments of the invention, the method        further comprises temporarily retaining the modular components        in the opened position by temporarily retaining the opposing        arms in the opened position. In one particular aspect of the        invention, the opposing arms are pivotally connected to one        another, and together define a ratchet connection employed in        temporarily retaining the opposing arms in the opened position.

These and other embodiments, features and advantages of the presentinvention will become even further apparent from the accompanyingdrawings, the following detailed description and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevated view in perspective of one embodiment of thepresent invention.

FIG. 2 is an elevated view in perspective of the embodiment of FIG. 1,shown in use to retract a surgical site on a human arm, isolating bonewithin that site.

FIG. 3 is an elevated view in perspective of a modular attachment inaccordance with one embodiment of this invention, which attachment couldbe used with the retractor assembly of FIG. 1.

FIG. 4 is an elevated view in perspective of another modular attachmentin accordance with one embodiment of this invention, which attachmentcould be used with the retractor assembly of FIG. 1.

FIG. 5 is an elevated view in perspective of another modular attachmentin accordance with one embodiment of this invention, which attachmentcould be used with the retractor assembly of FIG. 1.

FIG. 6 is an elevated view in perspective of another modular attachmentin accordance with one embodiment of this invention, which attachmentcould be used with the retractor assembly of FIG. 1.

FIG. 7 is an elevated view in perspective of a portion of the retractorassembly of FIG. 1, substituting modular attachments in accordance withFIG. 4 for the Hohmann-type retractor components shown in FIG. 1.

FIG. 8 is a top view of a Hohmann-type retractor component in accordancewith another embodiment of the invention.

FIG. 9 is an elevated view in perspective of a retractor assembly inaccordance with yet another embodiment of the invention.

FIG. 10 is a top view of the modified Hohmann-type retractor componentof the retractor assembly illustrated in FIG. 9.

Like numerical or alphabetic references identified within the severaldrawing figures are used to refer to like parts or components present inthe illustrated objects.

FURTHER DETAILED DESCRIPTION OF THE INVENTION

With surprising simplicity, the retractor assembly of this invention, inat least one of its embodiments, enables facile retraction of tissuefrom a surgical field, even when an assistant is not readily availableor only a single hand is free to manipulate the retractor. Selectembodiments of the invention also provide the convenience of a modularconfiguration, permitting of variations in the components configured tobe engaged by the posts extending substantially laterally from theopposing retractor arms. In this way, the same main retractor assemblyof opposed arms and associated lateral posts may be mated selectivelywith a specific pair or set of the same or different modular components,selected as best adapted for use in the given surgical procedure athand.

The one or more posts extend substantially laterally from the opposingretractor arms in that they may extend within the same general planeoccupied by the opposing arms, or may have a longitudinal axis which isdisposed at an angle relative to the general plane occupied by theopposing arms. In some embodiments of the invention, it may bedesirable, for example, for each post to extend laterally and slightlyupward from its associated opposing arm at an angle of, e.g., at least 5degrees or more from a plane generally occupied by the adjacent opposingarms of the assembly. Such angular disposing of the one or more postscan serve to at least ensure the modular components of the assemblyremain mated to their respective one or more post during use of theretractor assembly.

Turning now to the figures, it will be seen that a particular embodimentof this invention is illustrated by the self-retaining retractorassembly A shown in FIG. 1. Assembly A comprises two opposing retractorarms 10 and 12 disposed adjacent to one another and sized and configuredto be urged substantially laterally away from one another duringactuation of the refractor assembly into an open position. In theillustrated embodiment, such sizing and configuration is provided bypivotally connecting arms 10 and 12 to one another at pin 14, arms 10and 12 forming thumb and finger loops 16 and 18, respectively, andfurther forming a ratchet component itself formed by a curved flange 20defining ratchet teeth 21 and a spring-biased ratchet claw 22. Teeth 21and claw 22 mate with one another to releasably retain arms 10 and 12 inan open position (i.e., a position which will urge the surgicalfield-engaging portions of the retractor arms away from one another)when loops 16 and 18 of arms 10 and 12 are brought together manually.Biasing claw 22 to release from teeth 21 when desired will free theopposing arms 10 and 12 so that they may be placed in a closed positionwhen loops 16 and 18 are separated. At the opposing ends of arms 10 and12, there are provided a plurality of posts 30 each being connected to,or integral with, and extending radially outwardly from a respective oneof the opposing arms 10 and 12. As illustrated, one of each set of threeposts 30 extending from each of arms 10 and 12 is mated with a modularcomponent in the form of a Hohmann retractor 40 a and 40 c,respectively. Each of retractors 40 a and 40 c form at least one, and asillustrated at least two, shaped apertures 42, sized and configured totightly mate in a lock-and-key fashion with a respect one of the posts30. In this context, to tightly mate means that the clearance between aninner wall of at least one (and preferably each) aperture 42 and atleast one lateral side of its associated post 30 is sufficiently smallso as to allow for less than 15 degrees of rotation of the modularcomponent about the longitudinal axis of the post, thereby providing arelatively snug mating of the post 30 with its respective aperture 42 toprevent retractors 40 a and 40 c excessive movement about thelongitudinal axis of associated post 30, without being so snug thatretractors 40 a and 40 c cannot be readily de-coupled from theassociated posts 30 manually. This fit between each post and itsassociated modular component aperture is particularly important when themodular component is configured to detachably attach to a respective armby mating only one aperture with one post when installed in theassembly. As illustrated in FIG. 1, the Hohmann retractors 40 a and 40 cfurther define a series of two or more apertures 42 in order to provideoptions to the user to adjust the depth or other position of the modularcomponent attachment, in this case the retractors 40 a and 40 c. Whenmultiple apertures are defined by the modular component(s), theapertures in a given modular component may be the same shape ordifferent shapes.

For example, as seen in FIG. 8, in order to provide options for tiltingthe Hohmann retractor 60 (which is similar to retractor 40 a and 40 c ofFIG. 1) laterally at different depths and at different angles fromperpendicular during use, retractor 60 defines three different apertures62, 64 and 66, and the rectangular shape of aperture 66 is longer thanaperture 64, which is longer again than aperture 62, so that the usercan vary the angular tilt of the retractor component by employing theappropriate aperture for a preferred angle. The longer rectangularapertures 64 and 66 permit and upper portion of refractor 60 to tiltfrom perpendicular laterally (as shown for retractors 40 a and 40 c inFIG. 1) at greater respective degrees as compared to aperture 62, whilestill providing sufficiently small lateral post clearance to preventexcessive rotational motion of retractor 60 about the longitudinal axisof post 30 when employed in the assembly of this invention. FIGS. 9 and10 illustrate alternative Hohmann retractors 80 a and 80 c, each alsodefining multiple shaped apertures 82 (described in greater detailbelow) along the length of the retractor, in order to provide optionsfor tilting laterally at different depths and at different angles fromperpendicular during use.

In FIG. 2, the assembly of FIG. 1 is illustrated in use, but with twopairs of Hohmann retractors 40 a and 40 b, and 40 c and 40 d, mated torespective posts 30. The Hohmann retractors illustrated extend into asurgical site S and extend under a bone B. Assembly A is in an openposition to retain tissue T away from bone B during the procedure and tofurther isolate bone B. Through the use of a plurality of posts 30 andthe two pair of retractors 40 a, 40 b, and 40 c, 40 d, a well-retainedsurgical field can be obtained with effective isolation of bone B withone manual actuation of the self-retaining retractor assembly's rachetcomponent by manually bringing together loops 16 and 18 once the Hohmannretractors 40 a, 40 b, 40 c and 40 d are positioned into the field S andadjacent bone B.

FIG. 2 further illustrates the method of this invention, for positioningtissue during a surgical procedure. With reference to FIG. 2 and FIG. 7,it can be seen that, in practicing the method, one detachably attaches amodular component (e.g., the Hohmann retractors of FIG. 2) to each oftwo opposing arms 10 and 12 of the self-retaining retractor assembly, byat least mating respectively one or more apertures 42 defined by arespective one of the modular components (Hohmann retractors) with oneor more posts 30, the one or more posts being connected to or integralwith and extending radially outwardly from a respective one of theopposing arms 10 or 12. The method further comprises disposing at leasta portion of the modular components of each of the two opposing arms 10and 12 into the surgical field, and urging the opposing arms 10 and 12laterally away from one another and into an open position so as to placethe modular components into contact with, and to position, the tissueduring the surgical procedure. Such urging is typically, but notnecessarily, carried out manually by the user. The method may furthercomprise temporarily retaining the modular components in the openedposition by temporarily retaining the opposing arms 10 and 12 in theopened position. As illustrated, this is carried out through the use ofthe ratchet component of the assembly and a pivoting connection of theopposing arms, but of course other means of carrying out such retentioncan be envisioned once the feature of this invention are known. Forexample, fasteners such as screws, bolts and nut configurations, and thelike, or clamps or other mechanical components could be employed tocontrollably and temporarily retain the opposing arms in the openedposition and/or vary the space between those opposing arms during use.

The present invention is modular in that alternative or additionalmodular components can be provided to mate with the substantiallylaterally extending posts of the opposed arms of the retractor assembly.Thus, for example, as seen in FIGS. 3, 4, 5 and 6, a wide variety ofmodular components, in addition to or as an alternative to a Hohmannrefractor component, can be envisioned for use as a part of the assemblyof the invention. As seen in those figures, the modular componentcomprises a plate 50 which forms one or more flanges 52 and defines oneand one or more apertures 42, and the plate 50 can vary widely in itsshape and configuration, in order to suit a particular surgical need orprocedure.

FIG. 7 further illustrates another embodiment of the invention, and themating of a modular component 50 in accordance with FIG. 3 withretractor assembly arms 10 and 12.

In another aspect of the invention illustrated with reference to FIGS. 9and 10, there is provided a self-retaining retractor assembly B withseveral features similar to those of the assembly A of FIG. 1. AssemblyB further provides Hohmann retractor components 80 a and 80 c whichdefine key-hole type apertures 82 for receiving and mating with modifiedposts 32 which are connected to or integral with and extending radiallyoutwardly from a respective one of the opposing arms 10 or 12. Posts 32are each modified from the posts 30 illustrated in the assembly of FIG.1, in that posts 32 each define an enlarged section or head at the freeend, the enlarged section being sized and configured to be receivedthrough a mating portion of a respective shaped aperture 82. Once theenlarged portion of each post 32 has been received through itsrespective aperture 82, retractor 80 a or 80 c can be positioned so thatthe respective narrower portion of aperture 82 mate with the respectivenarrower section of post 32, as previously illustrated and described forposts 30 and aperture 42 of FIG. 2. This can reduce rotational movementof the respective Hohmann-type retractor component, while the enlargedportion of each post 32 will inhibit unintentional displacement orremoval of the respective Hohmann-type retractor component from itsassociated post. It should be appreciated from this disclosure by thoseof skill in the art, that the particular shapes of the key-hole typeapertures and mating posts (including the associated enlarged headportion of each) can vary from those illustrated while remaining withinthe spirit and scope of the invention.

As illustrated in FIG. 9, to illustrate another alternative design,assembly B further includes a pair of retention paddles, each in theform of a plurality of adjacent curved flanges 90, affixed to andextending in the same general direction from respective ends of the twoopposing arms 10 and 12 of assembly B. While as illustrated theretention paddles are integral with the opposing arms, it will beappreciated that these retention elements also may be modular in design,so that either or each is configured to be readily attached and detachedto its respective opposing arm.

Those of skill in the art will now appreciate that a wide variety ofmodular components could be sized and configured for use in theretractor assembly of this invention for use in many different types ofsurgical procedures. Moreover, a variety of sizes and configurations maybe employed to provide a mechanism for bringing together and urgingapart and retaining in place the opposing arms of the retractorassemblies of this invention, and those of skill in this art will nowappreciate that the specific self-retaining mechanism illustrated in theaccompanying figures is not the only configuration which could beemployed to effectuate the positioning and retention of the opposingarms and associated modular components during use. Likewise, the numberof apertures defined by the modular components, the number of laterallyextending posts and their specific length and lateral position relativeto the associated opposing arm, as well as the size and the shape andthe number of modular components employed, can vary to accommodatedifferent but desirable design criteria for a given retractor assemblyof the invention, or to better facilitate retraction in a given surgicalprocedure. Likewise, the length of the opposing arms can be varied toincrease the retraction. Due to the modular design of the assembly ofthis invention, various modular component attachments can be appliedalone or in combination. One type can be used on one arm and a differenttype on the other. The design also allows for the addition or removal ofthe modular component attachments during surgical procedure. The modularcomponents and other parts of the retractor assembly of this inventioncan be fabricated of any surgical grade material suitable for use inconventional retractor assemblies.

The foregoing description of various embodiments of the presentinvention are illustrative only, and are not to be construed as limitingthe scope of the invention. Many varying and different embodiments ofthe invention not specifically detailed herein nevertheless may beenvisioned easily by those of skill in the art who have the benefit ofthe present disclosure, and therefore the scope of the invention isproperly defined by the appended claims and equivalents thereofpermitted as a matter of law.

1. A retractor assembly for positioning tissue during a surgicalprocedure, the assembly comprising: two opposing arms disposed adjacentto one another and sized and configured to be urged substantiallylaterally away from one another during actuation of the retractorassembly into an open position, one or more posts, each being connectedto, or integral with, and extending radially outwardly from a respectiveone of the opposing arms and away from a space defined between the arms,and at least two modular components, each of the one or more postshaving a length sufficient so that each of the one or more posts willextend through a respective rectangular aperture defined by a respectiveone of the modular components to be detachably attached to therespective one of the opposing arms, the rectangular aperture beingsized and configured to enable the respective modular component to tiltlaterally relative to its respective post while being detachablyattached to the respective one of the opposing arms and engaged withtissue during use of the retractor assembly, each rectangular aperturebeing sized and configured to mate with a respective one of the posts tothereby detachably attach the modular component to the arm from whichthe respective one of the posts extends, wherein at least one of the oneor more posts defines an enlarged portion at a free end of the post. 2.A retractor assembly according to claim 1, further comprising at leastone modular component, which component defines two or more rectangularapertures along its length, each rectangular aperture being sized andconfigured to mate with the enlarged portion of the free end to therebydetachably attach the modular component to the arm from which therespective one of the posts extends.
 3. A retractor assembly accordingto claim 2, wherein each rectangular aperture defined by the modularcomponent is sized and configured also to mate with the respective oneof the posts so as to inhibit rotational motion of the modular componentabout the longitudinal axis of the respective one of the posts.
 4. Amethod of positioning tissue during a surgical procedure, the methodcomprising detachably attaching a modular component to each of twoopposing arms of a self-retaining retractor assembly, by at least matingrespectively one or more rectangular apertures defined by a respectiveone of the modular components with one or more posts, the one or moreposts being connected to or integral with and extending radiallyoutwardly from a respective one of the opposing arms, and therectangular apertures being sized and configured to enable therespective modular component to tilt laterally while detachably attachedto the respective one of the opposing arms and engaged with tissueduring use of the retractor assembly; disposing at least a portion ofthe modular components of each of the two opposing arms into a surgicalfield; and urging the opposing arms laterally away from one another andinto an open position so as to tilt the modular components laterally andplace the modular components into contact with and to isolate the tissueduring the surgical procedure.
 5. A method according to claim 4, furthercomprising temporarily retaining the modular components in the openedposition by temporarily retaining the opposing arms in the openedposition.
 6. A method according to claim 5, wherein the opposing armsare pivotally connected to one another, and together define a ratchetconnection employed in temporarily retaining the opposing arms in theopened position.
 7. A method according to claim 4, wherein the modularcomponents each define two or more rectangular apertures along theirrespective lengths, and the method further comprises adjusting the depthinto which each modular component extends into the surgical field bymating at least one of the posts to a different one of the rectangularapertures of its respective modular component.
 8. A method according toclaim 4 wherein the tissue comprises bone.